Virtual indentation of the empty capsid of the minute virus of mice using a minimal coarse-grained model.

A minimal coarse-grained model for T=1 viral capsids assembled from 20 protein rigid trimers has been designed by extending a previously proposed form of the interaction energy written as a sum of anisotropic pairwise interactions between the trimeric capsomers. The extension of the model has been performed to properly account for the coupling between two internal coordinates: the one that measures the intercapsomer distance and the other that gives the intercapsomer dihedral angle. The model has been able to fit with less than a 10% error the atomic force microscopy (AFM) indentation experimental data for the empty capsid of the minute virus of mice (MVM), providing in this way an admissible picture of the main mechanisms behind the capsid deformations. In this scenario, the bending of the intercapsomer dihedral angle is the angular internal coordinate that can support larger deformations away from its equilibrium values, determining important features of the AFM indentation experiments as the elastic constants along the three symmetry axes of the capsid and the critical indentations. From the value of one of the parameters of our model, we conclude that trimers in the MVM must be quite oblate tops, in excellent agreement with their known structure. The transition from the linear to the nonlinear regimes sampled in the indentation process appears to be an interesting topic for future research in physical virology.

Surgical Treatment in Post-Stroke Spastic Hands: A Systematic Review.

Background: For more than two decades, the surgical treatment of post-stroke spastic hands has been displaced by botulinum toxin therapy and is currently underutilized. Objectives: This article aimed to assess the potential of surgery for treating a post-stroke spastic upper extremity through a systematic review of the literature on surgical approaches that are adopted in different profiles of patients and on their outcomes and complications. Methods: Medline PubMed, Web of Science, SCOPUS, and Cochrane Library databases were searched for observational and experimental studies published in English up to November 2022. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluations (GRADE) system. Results: The search retrieved 501 abstracts, and 22 articles were finally selected. The GRADE-assessed quality of evidence was low or very low. The results of the reviewed studies suggest that surgery is a useful, safe, and enduring treatment for post-stroke spastic upper extremities, although most studied patients were candidates for hygienic improvements alone. Patients usually require an individualized combination of techniques. Over the past ten years, interest has grown in procedures that act on the peripheral nerve. Conclusions: Despite the lack of comparative studies on the effectiveness, safety, and cost of the treatments, botulinum toxin has displaced surgery for these patients. Studies to date have found surgery to be an effective and safe approach, but their weak design yields only poor-quality evidence, and clinical trials are warranted to compare these treatment options.

Spectroradiometry with sub-microsecond time resolution using multianode photomultiplier tube assemblies.

Accurate and precise measurements of spectroradiometric temperature are crucial for many high pressure experiments that use diamond anvil cells or shock waves. In experiments with sub-millisecond timescales, specialized detectors such as streak cameras or photomultiplier tubes are required to measure temperature. High accuracy and precision are difficult to attain, especially at temperatures below 3000 K. Here, we present a new spectroradiometry system based on multianode photomultiplier tube technology and passive readout circuitry that yields a 0.24 µs rise-time for each channel. Temperature is measured using five color spectroradiometry. During high pressure pulsed Joule heating experiments in a diamond anvil cell, we document measurement precision to be ±30 K at temperatures as low as 2000 K during single-shot heating experiments with 0.6 µs time-resolution. Ambient pressure melting tests using pulsed Joule heating indicate that the accuracy is ±80 K in the temperature range 1800-2700 K.

Social and clinical predictors of perianal colonisation by multidrug-resistant bacteria for geriatric patients in the internal medicine service.

BACKGROUND: Colonisation by multidrug-resistant (MDR) bacteria is a global health issue. The identification of patients with a higher risk of colonisation is essential. Patients admitted to internal medicine services might represent a vulnerable population with a high risk of colonisation. This study was the first to assess social and clinical variables associated with a higher risk of perianal colonisation by MDR bacteria in a Spanish cohort of patients admitted to internal medicine service. METHODS: Patients admitted to an internal medicine service during 12 months of recruitment (1 March 2022 to 1 March 2023) were included in the study. Perianal swabs were performed at admission to identify the presence of MDR bacteria. Social and clinical variables were collected following a directed acyclic graph. A cluster analysis was performed to identify clinical profiles of higher risk. Bivariate analyses and multivariable logistic regression models were fitted to identify potential predictors of MDR bacteria colonisation. RESULTS: A total of 245 patients, according to the required sample size, were included. Of them, 46 (18.8%) were colonised by MDR bacteria in perianal swabs. Female sex, age > 80 years, dependency on activities of daily living, cognitive deterioration and living in long-term care facilities constituted the highest risk clinical profile. After adjustments, living in long-term care facilities and malnutrition remained the main risk factors identified. CONCLUSION: Patients admitted to internal medicine services presented a high frequency of perianal colonisation by MDR bacteria. Social and clinical variables associated with bio-psycho-social susceptibility were associated with colonisation. Special surveillance is needed in internal medicine services to control the transmission.

Desarrollo de la Psicomotricidad en Estudiantes de Odontología Durante el Confinamiento por COVID-19

Las habilidades psicomotrices son un pilar fundamental del aprendizaje en odontología y clásicamente han sido trabajadas a través de la simulación o atención de pacientes. Durante el confinamiento debido a COVID-19, los estudiantes no tuvieron factibilidad de realizar procedimientos preclínicos. Debido a esto, se implementaron sesiones de entrenamiento de habilidades psicomotrices, en formato online, que permitieran preparar a los estudiantes durante el confinamiento para el retor no a la clínica. Se implementaron sesiones de entrenamiento psicomotriz a través de la utilización de materiales de artes plástica s e instrumental odontológico en formato online y guiados por una Terapeuta ocupacional. Para su medición, se realizó un estudio de casos y controles, donde los grupos se seleccionaron por conveniencia entre estudiantes que participaron de las sesiones y aquellos que tuvieron la formación virtual tradicional. La experiencia se evaluó a través cuestionario de autopercepción contestado por los estudiantes con respuestas en una escala de Likert y se comparó a través de pruebas estadísticas no paramétricas. Se recolectó una muestra total de 27 estudiantes, con una edad promedio de 23,7 años. Al comparar las respuestas de ambos grupos, los estudiantes del grupo casos percibieron significativamente una mejor sujeción de objetos pequeños utilizando pinzas, manipulación de instrumentales manuales y rotatorios de manera más precisa y mejor coordinación entre ambas manos durante un procedimiento simple en boca en comparación al grupo que no participó de las mismas. El entrenamiento de habilidades psicomotrices realizadas durante el periodo de confinamiento mostró resultados positivos en la percepción de las habilidades psicomotrices de los estudiantes, siendo una estrategia de bajo costo para ser implementada durante la formación de destrezas de los estudiantes de odontología en diferentes contextos. Sin embargo, para una mejor implementación debe estar en conjunto a estrategias de simulación para ser totalmente efectiva.

Psychomotor skills are a fundamental pillar of learning in dentistry and traditionally have been worked on through simulation or patient care. During the confinement due to COVID-19, students were not able to perform preclinical procedures. Due this, psychomotor skills training sessions were implemented, in online format to prepare students during confinement for the return to the patient care. Psychomotor training sessions were implemented using plastic arts materials and dental instruments in online format and guided by an occupational therapist. For its measurement, a case-control study was carried out, where the groups were selected by convenience between students who participated in the sessions and those who had traditional virtual training. The experience was evaluated through a self- perception questionnaire answered by the students with answers on a Likert scale and compared through non- parametric statistical tests. A total sample of 27 students was collected, with an average age of 23.7 years. When comparing the responses between groups, the students in the case group perceived significantly better grasping of small objects using forceps, more precise manipulation of hand and rotary instruments and better coordination between both hands during a simple mouth procedure compared to the group that did not participate in the same. The psychomotor skills training performed during the confinement period showed positive results in the perception of psychomotor skills of the students, being a low-cost strategy to be implemented during the skills training of dental students in different contexts. However, for a better implementation it should be in conjunction with simulation strategies to be fully effective.

Trihydrogen Cation Helium Clusters: A New Potential Energy Surface.

We present a new analytical potential energy surface (PES) for the interaction between the trihydrogen cation and a He atom, H 3 + - H e ${{H}_{3}^{+}-He}$ , in its electronic ground state. The proposed PES has been built as a sum of two contributions: a polarization energy term due to the electric field generated by the molecular cation at the position of the polarizable He atom, and an exchange-repulsion and dispersion interactions represented by a sum of "atom-bond" potentials between the three bonds of H 3 + ${{H}_{3}^{+}}$ and the He atom. All parameters of this new PES have been chosen and fitted from data obtained from high-level ab-initio calculations. Using this new PES plus the Aziz-Slaman potential for the interaction between Helium atoms and assuming pair-wise interactions, we carry out classical Basin-Hopping (BH) global optimization, semiclassical BH with Zero Point Energy corrections, and quantum Diffusion Monte Carlo simulations. We have found the minimum energy configurations of small He clusters doped with H 3 + ${{H}_{3}^{+}}$ , H 3 + H e N ${{H}_{3}^{+}{\left(He\right)}_{N}}$ , with N=1-16. The study of the energies of these clusters allows us to find a pronounced anomaly for N=12, in perfect agreement with previous experimental findings, which we relate to a greater relative stability of this aggregate.

Correction: Helium nanodroplets as an efficient tool to investigate hydrogen attachment to alkali cations.

Correction for 'Helium nanodroplets as an efficient tool to investigate hydrogen attachment to alkali cations' by Siegfried Kollotzek et al., Phys. Chem. Chem. Phys., 2023, 25, 462-470, https://doi.org/10.1039/D2CP03841B.

Forecasting levels of serum 25-hydroxyvitamin D based on dietary intake, lifestyle and personal determinants in a sample of Southern Europeans.

Vitamin D is an essential nutrient to be consumed in the habitual dietary intake, whose deficiency is associated with various disturbances. This study represents a validation of vitamin D status estimation using a semi-quantitative FFQ, together with data from additional physical activity and lifestyle questionnaires. This information was combined to forecast the serum vitamin D status. Different statistical methods were applied to estimate the vitamin D status using predictors based on diet and lifestyle. Serum vitamin D was predicted using linear regression (with leave-one-out cross-validation) and random forest models. Intraclass correlation coefficients, Lin's agreement coefficients, Bland-Altman plots and other methods were used to assess the accuracy of the predicted v. observed serum values. Data were collected in Spain. A total of 220 healthy volunteers aged between 18 and 78 years were included in this study. They completed validated questionnaires and agreed to provide blood samples to measure serum 25-hydroxyvitamin D (25(OH)D) levels. The common final predictors in both models were age, sex, sunlight exposure, vitamin D dietary intake (as assessed by the FFQ), BMI, time spent walking, physical activity and skin reaction after sun exposure. The intraclass correlation coefficient for the prediction was 0·60 (95 % CI: 0·52, 0·67; P < 0·001) using the random forest model. The magnitude of the correlation was moderate, which means that our estimation could be useful in future epidemiological studies to establish a link between the predicted 25(OH)D values and the occurrence of several clinical outcomes in larger cohorts.

Observation of Multiple Ordered Solvation Shells in Doped Helium Droplets: The Case of HeNCa2.

In this Letter, we report the experimental detection of likely the largest ordered structure of helium atoms surrounding a monatomic impurity observed to date using a recently developed technique. The mass spectrometry investigation of HeNCa2+ clusters, formed in multiply charged helium nanodroplets, reveals magic numbers at N = 12, 32, 44, and 74. Classical optimization and path integral Monte Carlo calculations suggest the existence of up to four shells surrounding the calcium dication which are closed with well-ordered Mozartkugel-like structures: He12Ca2+ with an icosahedron, the second at He32Ca2+ with a dodecahedron, the third at He44Ca2+ with a larger icosahedron, and finally for He74Ca2+, we find that the outermost He atoms form an icosidodecahedron which contains the other inner shells. We analyze the reasons for the formation of such ordered shells in order to guide the selection of possible candidates to exhibit a similar behavior.

Many-Body Contributions in Water Nanoclusters.

Many-body interactions in water are known to be important but difficult to treat in atomistic models and often are included only as a correction. Polarizable models treat them explicitly, with long-range many-body potentials, within their classical approximation. However, their calculation is computationally expensive. Here, we evaluate how relevant the contributions to the many-body interaction associated with different coordination shells are. We calculate the global energy minimum, and the corresponding configuration, for nanoclusters of up to 20 water molecules. We find that including the first coordination shell, i.e., the five-body term of the central molecule, is enough to approximate within 5% the global energy minimum and its structure. We show that this result is valid for three different polarizable models, the Dang-Chang, the MB-pol, and the Kozack-Jordan potentials. This result suggests a strategy to develop many-body potentials for water that are reliable and, at the same time, computationally efficient.

Antimicrobial potential of new diclofenac hydrogels for disinfection in regenerative endodontics: An in vitro and ex vivo study.

AIM: There is a need to explore new alternatives for root canal disinfection in regenerative endodontics, since the current strategies are far from ideal. Currently, the potential use of diclofenac (DC) is being investigated for controlling root canal infections. The objective was to evaluate the antimicrobial efficacy of novel DC-based hydrogels (DCHs) against polymicrobial biofilms grown in radicular dentine and root canals and to compare results with triantibiotic (TAH) and diantibiotic (DAH) hydrogels, and calcium hydroxide (Ca[OH]2 ). METHODOLOGY: The in vitro antimicrobial activity of intracanal medicaments was evaluated against 3-week-old polymicrobial root canal biofilms grown on human radicular dentine. Dentine samples were obtained and randomly divided into the study groups (n = 4/group): (1) 1 mg/ml TAH; (2) 1 mg/ml DAH; (3) 5% diclofenac (DCH); (4) 2.5% DCH; (5) 1.25% DCH; (6) 1 mg/ml DAH + 5% DCH; (7) Ca(OH)2 paste; (8) positive control. The microbial viability, in terms of percentage of intact cell membranes, was assessed after 7 days by confocal scanning laser microscopy (CSLM). The ex vivo efficacy of intracanal medications was evaluated in root canals infected with a polymicrobial suspension. Intracanal microbiological samples at baseline (S1) and 7 days post-treatment (S2) were taken; microbial quantification and cell viability were assessed by quantitative polymerase chain reaction (qPCR) and flow cytometry (FC). The mean Log10 of bacterial DNA copies in root canal samples before (S1) and the Log10 reduction of DNA copies S1-S2 in qPCR were recorded. The absolute value of total cells stained, and the percentage reduction of intact membrane cells after treatment (S1-S2), were analysed by FC. Global comparison was done using the Kruskal-Wallis test, whilst the Mann-Whitney U test was used for pair-by-pair comparison. RESULTS: Confocal scanning laser microscopy analysis indicated that the greatest effectiveness was obtained with 5% DCH, showing significant differences with respect to the other groups (p < .001). In root canals, the highest Log10 DNA reduction S1-S2 was obtained with 5% DCH and TAH, with no differences between them. The results of FC showed that only 5% DCH proved significantly superior to the other treatments. CONCLUSIONS: Sodium DC hydrogels demonstrate antimicrobial efficacy against endodontic biofilms.

Implications of differential peroxyl radical-induced inactivation of glucose 6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase for the pentose phosphate pathway.

Escherichia coli glucose-6-phosphate dehydrogenase (G6PDH) and 6-phosphogluconate dehydrogenase (6PGDH) are key enzymes of the pentose phosphate pathway, responsible for the NADPH production in cells. We investigated modification of both enzymes mediated by peroxyl radicals (ROO·) to determine their respective susceptibilities to and mechanisms of oxidation. G6PDH and 6PGDH were incubated with AAPH (2,2'-azobis(2-methylpropionamidine)dihydrochloride), which was employed as ROO· source. The enzymatic activities of both enzymes were determined by NADPH release, with oxidative modifications examined by electrophoresis and liquid chromatography (LC) with fluorescence and mass (MS) detection. The activity of G6PDH decreased up to 62.0 ± 15.0% after 180 min incubation with 100 mM AAPH, whilst almost total inactivation of 6PGDH was determined under the same conditions. Although both proteins contain abundant Tyr (particularly 6PGDH), these residues were minimally affected by ROO·, with Trp and Met being major targets. LC-MS and in silico analysis showed that the modification sites of G6PDH are distant to the active site, consistent with a dispersed distribution of modifications, and inactivation resulting from oxidation of multiple Trp and Met residues. In contrast, the sites of oxidation detected on 6PGDH are located close to its catalytic site indicating a more localized oxidation, and a consequent high susceptibility to ROO·-mediated inactivation.

Helium nanodroplets as an efficient tool to investigate hydrogen attachment to alkali cations.

We report a novel method to reversibly attach and detach hydrogen molecules to positively charged sodium clusters formed inside a helium nanodroplet host matrix. It is based on the controlled production of multiply charged helium droplets which, after picking up sodium atoms and exposure to H2 vapor, lead to the formation of Nam+(H2)n clusters, whose population was accurately measured using a time-of-flight mass spectrometer. The mass spectra reveal particularly favorable Na+(H2)n and Na2+(H2)n clusters for specific "magic" numbers of attached hydrogen molecules. The energies and structures of these clusters have been investigated by means of quantum-mechanical calculations employing analytical interaction potentials based on ab initio electronic structure calculations. A good agreement is found between the experimental and the theoretical magic numbers.

Microbiología de las infecciones periprotésicas de rodilla en Hospital Regional de Talca / Microbiology of periprosthetic knee infections in Regional Hospital

Introduction: Periprosthetic infection (PPI) is one of the most devastating complications of total knee arthroplasty (TKA). The incidence described in the literature is 2.4% and the most frequently isolated bacteria are Staphylococcus Aureus and Staphylococcus Coagulase-Negative (Gram positive). Polymicrobial infections represent between 10 to 37% and negative cultures between 7 to 15%. Methodology: Descriptive and retrospective study that consisted of reviewing the TKA database of the Regional Hospital of Talca during the 2018-2020 period, where knee PPIs were identified according to the diagnostic criteria validated in 2018. The cultures of patients diagnosed with PPI were reviewed, analyzing the antibiogram and resistance profile. Results: During 2018-2020, 459 TKAs were performed in our center, diagnosing 30 PPIs of the knee. 47% of PPIs were acute and 53% chronic. The results of the cultures were negative in 26.6%, 23.3% Methicillin Sensitive Staphylococcus Aureus; 13.3% Methicillin Resistant Staphylococcus Epidermidis and 13.3% of the cultures were polymicrobial. Discussion: Highlights the high resistance to methicillin, especially of Staphylococcus Epidermidis. This opportunistic pathogen has the ability to form a biofilm and, thanks to its genomic flexibility, rapidly acquires resistance to antibiotics. Polymicrobial infections have a synergistic effect that favors the persistence of the infection, which is why they will require a greater number of surgeries and prolonged antibiotic therapy. Pruebas especiales como la sonicación podrían aumentar las posibilidad de identificar al microorganismo. Conclusion: In these three years of follow-up, the PPI rate has been higher than reported annually in the literature. Gram-positive microorganisms continue to predominate, but with an increase in the rate of resistant to methicillin. Also, highlight the number of negative cultures. There would be a possible benefit theoretical in optimizing antibiotic prophylaxis in view of the large percentage of methicillin resistance and in seeking new ways to reduce negative cultures.

Tratamiento mínimamente invasivo/percutáneo de fracturas de pilón tibial con asistencia artroscópica en Hospital Regional de Talca / Minimally invasive/percutaneous treatment of tibial pilon fractures with arthroscopic assistance at the Regional Hospital

Tibial pilon fractures are a complex injury to treat due to the great involvement of soft and bone tissues. The classic surgical treatment is based on open reduction with internal fixation (ORIF), adding morbidity to the soft tissues, increasing the risk of complications. This has motivated the development of minimally invasive and/or percutaneous techniques to reduce complications, and with the advent of arthroscopy, achieve anatomical reductions. METHODS: A retrospective observational study of twelve patients with tibial pilon fractures who were treated in our center with minimally invasive and/ or percutaneous osteosynthesis with arthroscopic support was carried out between January 2019 and June 2021. Fractures were characterized using the AO/OTA classification for tibial pilon. Age, sex, fracture mechanism, exposure and initial management in the emergency department (cast immobilization or external fixation), definitive treatment, complications and clinical and functional evaluation twelve months after definitive osteosynthesis. For this last point, plantar flexion, dorsiflexion and the AOFAS and FAOS Score were measured. RESULTS: The operated patients were 12, 8 were men (67%) and 4 were women (33%). The average age was 49 (17-68) years. The definitive treatment was carried out after an average of 8 days (5-12 days). Surgical treatment schemes were as follows: percutaneous osteosynthesis with medial anatomical plate and arthroscopic support (OPAA), minimally invasive osteosynthesis with cannulated screws and arthroscopic support (OMIAA) and osteosynthesis with external circular guide and arthroscopic support (OTCAA). In the AOFAS Score, three patients had excellent results (≥ 90 points), 6 patients had good results (≥ 80 points) and 3 patients had acceptable results (≥ 70 points). In the FAOS Score, eight patients had over 80% (good results) and 4 patients had over 60% (accep - table results). DISCUSSION: Historically, tibial pilon fractures have been considered non-reconstructable and with poor long-term results. Initially this paradigm changed with the principles of Rüedi for the reconstruction of the tibial pilon and improve the results. ORIF has been widely used until today, it allows achieving an anatomical joint reduction, it allows to give stability and length to the fibula, graft contribution and sta - bilization with the medial plate. Today this concept is changing again, since the emphasis is on the care of the soft tissues to allow a better recovery of the patient and reduce the complications of the classic approach, it is in this context that the appearance of minimally invasive and/or percutaneous techniques with arthroscopic assistance has allowed us to have excellent functional and clinical results with less da - mage to the soft tissues. CONCLUSION: The proper management and care of the soft tissues in a high-energy fracture of the tibial pilon is essential to obtain favorable clinical results and thus achieve restoration of ankle function. Percutaneous and minimally invasive management has optimized management of the tibial pilon, redu - cing the rates of complications, amputation, and pri - mary arthrodesis.

Ventana cortical anterior para extracción de vástago en revisión de artroplastia total de cadera: una alternativa a la osteotomía trocantérica extendida / Anterior cortical window for stem extraction in total hip arthroplasty revision: an alternative to extended trochanteric osteotomy

Total hip arthroplasty (THA) is a safe and effective procedure in patients with end-stage ostheoarthritis. In the last years the indication for THA is increasingly in younger patients, associated with rising of life expectancy, this imply an increase in revision surgeries for various causes such as: aseptic loosening, fractures and infections. In this context and in view of the need to replace the femoral component, alternatives to the classic extended trochanteric osteotomy (ETO) arise, such as the anterior cortical window (ACW), which allows the rate of complications to be reduced with excellent results. We present the case of a 51-year-old patient who sustained one episode of dislocation, who required revision surgery due to aseptic loosenig, where the ACW was used for the extraction of the stem. In addition, a review of the literature was made to show advantages and complications regarding ETO.

Dermatological adverse reactions after vaccination with BNT162b2 in a cohort of healthcare workers.

BACKGROUND: The description of the skin reactions produced by the different vaccines against SARS-CoV-2 has focused on the symptoms reported by the general population. There are few studies with very different measurement methods focused on healthcare workers. METHODS: A longitudinal observational study was conducted on all the healthcare workers from the Hospital Universitario San Cecilio that received vaccination against COVID-19 with BNT162b2. The recruitment period was from December 2020 to September 2021. The recommended regimen was double, with a minimum interval of 21 days between doses. All dermatological reactions reported as adverse effects of the vaccine were evaluated by the Staff of the Dermatology Unit of our center. RESULTS: A total of 3969 healthcare workers of our center were followed. Only 0.7% of them reported dermatological adverse reactions. The most frequently reported reactions were morbilliform rash and COVID arm. In the multivariate analysis, the vaccination regimen (one dose) and the history of COVID-19 infection remained the main factors associated with the report of dermatological adverse reactions. CONCLUSION: The rate of dermatological adverse reactions after vaccination with BNT162b2 (Pfizer-BioNTech) is extraordinarily low. No patient required hospitalization, which supports the safety of this vaccination in a population of healthcare workers.

Artroplastia total de cadera bilateral en un tiempo: una opción quirúrgica para pacientes con coxartrosis severa bilateral / Simultaneous bilateral total hip arthroplasty: a surgical option for patients with several bilateral hip osteoarthritis

Total hip arthroplasty is a successful procedure with high rates of functional satisfaction and pain relief. A large number of patients with bilateral hip pathology will require both hip joint replacement, from there born the inquietude to knowing benefits and disadvantage of bilateral simultaneous hip arthroplasty. We present a female patient case who developed bilateral hip osteoarthritis secondary to development dysplasia of the hip which was surgically managed with bilateral arthroplasty at one time. We show a follow-up report of the case and a review of the literature to know the main advantages of this new current of hip arthroplasty in patients with bilateral hip pathology

Obesity and biochemical recurrence in clinically localised prostate cancer: a systematic review and meta-analysis of 86,490 patients.

BACKGROUND: The association of obesity with biochemical recurrence (BCR) after treatment of clinically localised prostate cancer (PC) shows inconsistent results. Our aim was to systematically review all evidence evaluating obesity as a prognostic factor for BCR. METHODS: We searched PubMed, Web of Science and Scopus, from inception to June 1, 2021. Cohort studies reporting BCR among PC patients stratified by body mass index (BMI) were included. To assess the quality of the selected studies, we used the Newcastle-Ottawa scale (NOS). Risk of BCR among obese patients (BMI ≥ 30 kg/m2) was compared with normal weight (BMI < 25), pooling individual hazard ratios (HR) in random-effect meta-analysis. Associations for continuous BMI per 5 kg/m2 were also calculated. Subgroup analyses were conducted to assess reasons for heterogeneity and causal criteria were formally evaluated. RESULTS: We identified 46 cohort studies including 86,490 PC patients. A total of 14,719 (17.1%) patients developed BCR. There was no consistent definition of BCR. Obesity was associated with BCR (HR: 1.25, 95% CI: 1.11-1.39, I2: 70.3%), and there was a 10% increase (95% CI: 4-15%, I2: 66.3%) in BCR per 5 kg/m2 increase in BMI. The heterogeneity was high but decreased in the subgroup of highest-quality NOS score and when the BMI was measured by the researchers (I2: 0.0%). The association was consistent in patients receiving radical prostatectomy but not in patients receiving other therapies. CONCLUSIONS: Obesity showed a moderate, consistent relationship with biochemical recurrence after radical prostatectomy. Measurement of BMI and BCR was variable, highlighting the need for standardised clinical guidelines. Preventive weight control programs may have a role in reducing BCR for clinically localised PC patients.

Ultrasound findings of lung ultrasonography in COVID-19: A systematic review.

PURPOSE: To identify the defining lung ultrasound (LUS) findings of COVID-19, and establish its association to the initial severity of the disease and prognostic outcomes. METHOD: Systematic review was conducted according to the PRISMA guidelines. We queried PubMed, Embase, Web of Science, Cochrane Database and Scopus using the terms ((coronavirus) OR (covid-19) OR (sars AND cov AND 2) OR (2019-nCoV)) AND (("lung ultrasound") OR (LUS)), from 31st of December 2019 to 31st of January 2021. PCR-confirmed cases of SARS-CoV-2 infection, obtained from original studies with at least 10 participants 18 years old or older, were included. Risk of bias and applicability was evaluated with QUADAS-2. RESULTS: We found 1333 articles, from which 66 articles were included, with a pooled population of 4687 patients. The most examined findings were at least 3 B-lines, confluent B-lines, subpleural consolidation, pleural effusion and bilateral or unilateral distribution. B-lines, its confluent presentation and pleural abnormalities are the most frequent findings. LUS score was higher in intensive care unit (ICU) patients and emergency department (ED), and it was associated with a higher risk of developing unfavorable outcomes (death, ICU admission or need for mechanical ventilation). LUS findings and/or the LUS score had a good negative predictive value in the diagnosis of COVID-19 compared to RT-PCR. CONCLUSIONS: The most frequent ultrasound findings of COVID-19 are B-lines and pleural abnormalities. High LUS score is associated with developing unfavorable outcomes. The inclusion of pleural effusion in the LUS score and the standardisation of the imaging protocol in COVID-19 LUS remains to be defined.